Abstract:AIM:To observe the effect of different concentrations Buddleja offcinalis eye drops(BOED)to inflammatory factors of lacrimal gland cells of castrated male rabbit with dry eye.

METHODS:Forty-two healthy adult New Zealand rabbits were randomly divided into 7 groups, 6 rabbits each group. Group A: blank group; Group B: model group; Group C: low concentrations BOED group; Group D: medium concentrations BOED; Group E: high concentrations BOED; Group F: the placebo group; Group G: testosterone groups. All rabbits of groups B to G were cut off bilateral testis and epididymis except group A. The rabbits of groups C, D, E and F were dropped relevant eye drops except groups A and B. All rabbits were tested for Schimer I test(SIT)and break-up time(BUT)before operation and 4wk after operation. Expressions of inflammatory factors of TNF-α, IL-1β from lacrimal gland cells were checked in immunohistochemical staining method.

RESULTS:1)Comparison of SIT and BUT: Compared with the groups D, E and G, group C had statistical significance(P<0.01). Compared with groups D and E, G groups, there was no significant difference among those group after operation(P>0.05); 2)Comparison of inflammatory factors of TNF-α, IL-1β after operation: Compared with value of the average optical density of TNF-α and IL-1β of group C, those of groups D, E and G were obviously different after operation(P<0.05). Compared D with E, G groups, there was no significant difference between those group after operation(P>0.05).

CONCLUSION: 1)Compared with androgen, BOED has the similar effect of depressing the expression of inflammatory factors. But its effect is slightly weaker than the androgen; 2)The depressing effect of medium and high concentration BOED are better than low concentration. Compared with medium and high concentration of BOED, there was no significant difference between two groups.

Abstract:AIM: To evaluate the clinical effectiveness of intrastromal corneal ring segments among the patients suffering from keratoconus.

METHODS: A retrospective and comparative interventional design had been utilized on the basis of postoperative follow up among 56 keratoconus patients. Visual acuity was significantly assessed during complete ophthalmic examination of the patients. The femtosecond laser had been used to create the corneal tunnels in 15 eyes; whereas, the corneal tunnels were created in 72 eyes mechanically.

RESULTS: The ranges and standard deviations had been used to obtain results. It had been revealed through ophthalmic assessment that the mean preoperative uncorrected visual acuity observed was 1.38±0.37 Logarithm of Minimal Angle of Resolution. Moreover, a significant improvement was observed postoperatively in visual acuity by 0.58±0.32 during the fourth month. The improvement was also witnessed in the 16^th month by 0.48±0.30.

CONCLUSION: The implantation of intrastromal corneal ring segments is an efficient and effective surgical intervention for the treatment of keratoconus. Thus, identified intervention seems to be associated with appropriate visual outcomes and safety after the development of femtosecond as well as mechanical tunnels.

Abstract:AIM:To determine the factors affecting the uptake of rural practice by trainee ophthalmologists in Nigeria.

METHODS: This cross sectional survey was conducted among Nigerian Ophthalmology resident doctors attending an annual Neuro-ophthalmology course jointly organized by the West African College of Surgeons and the Ophthalmological Society of Nigeria Southeast-South south zone(OSN SESS), preparatory to the part 1 and 2 fellowship examination from 15^th to 21^st June 2015. A pre-tested closed-ended questionnaire adapted and modified for this study was self-administered at the end of the course to all consenting participants. Data on respondent's socio-demographics and views about rural eye care services were collected. In addition, information was collected on the respondents' perception of rural practice, willingness to practice in the rural area, benefits and barriers to working in the rural area. Data were analyzed using the statistical package for social sciences(SPSS), version 19(SPSS Inc., Chicago, Illinois, USA). Descriptive analysis yielded measures of central tendency while comparative statistical tests for significance of observed inter-group differences was performed using Chi-square. In all comparisons, the P- value for statistical significance was set at P<0.05.

RESULTS: The total number of respondents was 44 aged 32.9±0.56y, comprising of 24(54.5%)males and 20 females with a male to female ratio of 1:0.8. All the respondents viewed the current state of rural service in Nigeria as unsatisfactory. Majority(75.0%)of the respondents were unwilling to practice Ophthalmology in rural areas. More females than males indicated willingness to work in the rural area. The commonest potential benefit of working in a rural area mentioned by the respondents was “health services for the poor/serving the country”(37; 84%)while all the respondents(44; 100%), noted absence of infrastructure/facilities as drawback to rural ophthalmic practice.

CONCLUSION: All the respondents in our survey had an unsatisfactory perception of Nigeria's rural eye-care service and majority were unwilling to work in a rural area.

Abstract:AIM: To investigate the effect of transplanted pigmented epithelium-derived factor(PEDF)on human umbilical cord-derived mesenchymal stem cells(hUCMSCs)in the treatment of retinitis pigmentosa in rat models.

METHODS: The hUCMSCs were isolated and cultured, hUCMSCs were transfected with PEDF recombinant lentivirus. Experimental royal college of surgeon(RCS)rats were randomly divided into 3 groups, 8 rats in each group. The experimental group was injected with PEDF-hUCMSCs subcutaneously. The hUCMSCs control group was injected with the same amount of hUCMSCs. The PBS control group was injected with the same amount of PBS. At 4 and 8wk after injection, electroretinography(ERG), the thickness of retinal outer nuclear layer(ONL)and green fluorescent protein(GFP)staining were observed. Immunofluorescence staining of retinal sections and the phagocytosis of MERTK protein were evaluated to determine phagocytosis.

RESULTS: PEDF gene carrying recombinant lentiviral vector could efficiently infect hUCMSCs. After infection, hUCMSCs were sub cultured and the lentivirus prolonged the expression in the cells of the target gene. At 8wk after transplantation, the amplitude of b-wave in ERG were significantly higher in the experimental group than in the control groups. At 4 and 8wk after transplantation, morphological changes of ONL thickness in the experimental group were significantly higher than those in the control groups(all P<0.05). At 4 and 8wk after transplantation, hUCMSCs infected by lentiviral vector carrying PEDF were found survival in the subretinal cavity by GFP staining, and the PEDF-hUCMSCs were found having phagocytosis for outer segment fragments of photorecepter cells by immunofluorescence staining. At 4 and 8wk after transplantation, the Protein band gray values in experimental group were significantly higher than that in control groups, which indicated that the expressions of MERTK protein in experimental group were also increased significantly, and the phagocytic capacity of RPE were improved.

CONCLUSION: Transplantation of pigment epithelium-derived protein modified human umbilical cord-derived mesenchymal stem cells has a protective effect on the retina of RCS rats.

Abstract:AIM: To investigate the effects of insulin on syndecan-1 expression, cellular permeability and proliferation in human retinal microvascular endothelial cells.

METHODS: Cells were treated with 100nmol/L and 1 000nmol/L insulin for 48h respectively. Expression of protein and mRNA were detected by western blot and quantitative real-time polymerase chain reaction. Cellular proliferation and permeability were examined by methods of methylthiazolyl tetrazolium and horseradish peroxidase.

RESULTS: With treatment of insulin, protein and mRNA of syndecan-1 both increased obviously, and the effect of high level insulin was more significant. After treated with insulin, cellular proliferation and permeability both enhanced, and the effects of high level insulin were stronger.

CONCLUSION: Insulin can up-regulate syndecan-1 protein and mRNA in cultured human retinal microvascular endothelial cells, and increase cellular permeability and proliferation.

Abstract:AIM: To investigate the effects of blue light and white light on the proliferation of human retinal pigment epithelial cell line(ARPE-19)at different times, and lay a foundation for further detecting the changes of related factors during photodamage and further studying the signal transduction mechanism during light damage.

METHODS:Well-grown ARPE-19 cells were collected for experimentation. The standard curve of CCK-8 was made to determine the proper cell density of ARPE-19 cells and the reaction time of CCK-8 reagent. The cells were divided into dark group, blue light group and white light group, which were irradiated for 3, 6 and 9h respectively. After 12h of light-repellent treatment, CCK-8 method was used to examine the effects of different light sources on the proliferation rate of ARPE-19 cells at different times.

RESULTS: The number of cells per well was selected by CCK-8 standard curve to be 20 000, and the corresponding absorbance value was measured after 4h of the action of CCK-8 solution. The CCK-8 test results showed that the cell proliferation rates of the three groups were significantly different(P<0.01). The cell proliferation rate of the blue light group was significantly different(P<0.001)at 3, 6 and 9h, and the cell proliferation rate decreased gradually with the extension of the illumination time. The cell proliferation rate of the white light group was significantly different(P<0.05)at 3, 6 and 9h; there was a statistically significant difference in the rate of cell proliferation at 3h and 6h in white light(P<0.05), however, there was no significant difference in the rate of cell proliferation at 9h illumination compared with 3h and 6h illumination respectively(P=0.253, 0.120). The proliferation rate of cells under white light for 3-6h showed a downward trend, while that of cells under light for 6-9h showed an upward trend. At the same illumination time, the proliferation rate of the cells in the blue and white groups was lower than that in the dark group, and the cell proliferation rate in the blue group was lower than that in the white group. The difference was statistically significant(P<0.05).

CONCLUSION: The proliferation of ARPE-19 cells was inhibited by light irradiation. The proliferation rate of cells in blue light group was significantly lower than that of white light group. With the increase of light time, the cell proliferation rate decreased.

Abstract:AIM: To investigate the expression of connexin43(Cx43)in retina of Sprague Dawley(SD)rats with diabetes mellitus(DM), and the effects of celecoxib, inhibitor of cyclooxygenase 2(COX-2), on expression of Cx43 in retina of them.

METHODS: DM was induced in SD rats by the administration of streptozotocin(STZ). DM rats were divided into two groups: COX-2 treated group(CTG, n=15), and diabetic group(DG, n=15). Normal control group(NCG)consisted of 15 rats was given. Three months' treatment was given after DM development. Sample of retina were made at the end of 3mo. Expression of Cx43 in retina were investigated by immunohistochemistry. Expression of Cx43 mRNA in retina were analyzed by RT-PCR.

RESULTS: Cx43 was expressed in the ganglion cell layer, the nerve fiber layer, the inner plexiform layer, and the pigment epithelium layer of retina with a different degree. Computer image analysis showed that celecoxib had elevated the expression of Cx43 in experimental diabetic rats, gray values were: 0.233±0.025, 0.124±0.014, 0.197±0.021; multiple comparisons found statistically significant difference(P<0.05). Celecoxib had raised the expression of Cx43 mRNA in diabetic rats with real time quantitative PCR. Relative value was 0.635±0.084, 0.110±0.061, 0.367±0.074, multiple comparisons found statistically significant difference(P<0.05).

CONCLUSION: Expression of Cx43 decreases in retina of SD rats with DM. Celecoxib can relieve the decrease of Cx43 expression in retina of them.

Abstract:AIM: To detect IL-6, IL-8 and TNF-α expression levels in serum and aqueous humor of patients with neovascular glaucoma(NVG)and explore the significance.

METHODS:A prospective case analysis method was applied to include patients with neovascular glaucoma in 38 cases(38 eyes), and according to grading criteria of iris neovascularization, they were divided into grade Ⅱ with 8 eyes, grade Ⅲ with 19 eyes, grade Ⅳ with 11 eyes. Thirty-one patients(31 eyes)with primary open angle glaucoma(POAG)and 33 patients(33 eyes)with age related cataract were selected as the control. IOP level was detected preoperatively, and venous blood and aqueous humor samples of patients were selected, and IL-6, IL-8 and TNF-α contents in serum and humor were detected by using enzyme linked immunosorbent assay(ELISA).

RESULTS:IL-6, IL-8 and TNF-α levels in serum and aqueous humor of NVG group were significantly higher than those in POAG group and cataract group(P<0.05). IL-6, IL-8 and TNF-α levels in serum and aqueous humor of POAG group were significantly higher than those in cataract group(P<0.05). IL-6, IL-8 and TNF-α levels in serum and aqueous humor of grade ⅣNVG group were significantly higher than those of patients with grade Ⅲ(P<0.05). IL-6, IL-8 and TNF-α levels in serum and aqueous humor of patients with grade Ⅲ were significantly higher than those of grade Ⅱ(P<0.05). IL-6, IL-8 and TNF-α levels in serum and aqueous humor of NVG patients were positively correlated with IOP(P<0.05).

CONCLUSION: IL-6, IL-8 and TNF-α are highly-expressed in serum and aqueous humor of NVG patients. It may be involved in iris neovascularization and intraocular pressure elevation.

Abstract:AIM: To compare the clinical efficacy and complications of intravitreal injection of 1mg, 2mg and 4mg triamcinolone acetonide(TA)in the treatment of macular edema secondary to retinal vein occlusion, and to explore effective and safe injection dose.

METHODS: Totally 62 patients(62 eyes)with venous obstructive macular edema were divided into 1mg intravitreal injection of TA(IVTA)group, 2mg IVTA group and 4mg IVTA group, including 18 cases in group 1mg, 22 cases in 2mg group, and 22 cases in 4mg group according to the dosage of intravitreous. The intravitreal injection of TA as the dosage of 1mg/0.025mL, 2mg /0.05mL, 4mg/0.1mL were taken. At 1, 3 and 6mo after the injection, the items including best corrected visual acuity(BCVA), central macular thickness center(CMT), intraocular pressure and complications were examined and compared between the three groups.

RESULTS: There was no significant difference in age, sex, course of disease, BCVA, CMT and intraocular pressure in the three groups before injection(P>0.05). In 1mg IVTA group, BCVA and CMT were improved 1 and 3mo after treatment, compared with those before treatment(P<0.05). In 2mg IVTA group and 4mg IVTA group, BCVA and CMT were superior to those before treatment at 1, 3 and 6mo after injection(P<0.05). At 3 and 6mo after injected, there was no difference in BCVA and CMT between 2mg IVTA group and 4mg IVTA group(P>0.05), which was better than that of 1mg IVTA group(P<0.05). There were 2 cases, 6 cases in 2mg IVTA group and 4mg IVTA group had elevated intraocular pressure respectively(≥22mmHg)and beta receptor blockers were used to reduce the intraocular pressure. Except 1 cases in need of antihypertensive drug, the intraocular pressure of the rest patients were normal(less than 21mmHg)in 6mo follow-up period.

CONCLUSION: The 2mg triamcinolone acetonide may be a suitable dose of intravitreous intravitreal injection for the treatment of macular edema secondary to retinal vein occlusion.

Abstract:Tauroursodeoxycholic acid(TUDCA)is formed by taurine conjugated of ursodeoxycholic acid(UDCA). It has the role of neurotrophic factor in anti-inflammatory, anti-apoptosis and reducing the activation of microglial cells. These effects may be one of the most critical of all pathological stages of retinitis pigmentosa. Preclinical trials have shown that TUDCA had potential therapeutic value for retinal degeneration disease. This article discusses how TUDCA can slow down the process of retinal degeneration.

Abstract:Retinoblastoma(RB)is the most common intraocular malignant tumor in infants, the pathogenesis of which, is related to gene mutations. In order to improve the survival rate and eye-protection rate of RB patients, the therapeutic approaches have been constantly updated and developed, mainly including chemotherapy, radiation therapy, surgical treatment, physiotherapy, photochemotherapy, gene therapy at present. In this article, we mainly reviewed the progress of RB treatment.

Abstract:In recent years,with the widespread application of highly effective antiretroviral therapy(HAART), the incidence of human immunodeficiency virus(HIV)and acquired immunodeficiency syndrome(AIDS)related eye complications was significantly reduced. The absolute number of patients infected with HIV and AIDS increased year by year, and the survival rate increased and the survival time prolonged. The clinical manifestations of associated ocular complications in these patients are variable, affecting almost all ocular structures. At present, there is a lack of large-scale and long-term systematic observation of eye lesions in HIV-infected and AIDS patients in China. Misdiagnosis and missed diagnosis occur in many hospitals and even in some of the top-three hospitals. This not only delays the treatment of patients, but also easily cause iatrogenic transmission. Therefore, ophthalmologists and even other medical workers should enhance their knowledge of HIV/AIDS. This paper reviews the common complications of non-infection, opportunistic infection, and immune reconstitution inflammatory response syndrome(IRIS)in the HIV/AIDS patients, and discusses the manifestations and research progress of posterior ocular complications of HIV/AIDS.

Abstract:As magnetic resonance imaging(MRI)technology has the features of non-invasive, clear imaging, and high resolution to soft tissue, it has been used to both the clinic applications and basic researches of ophthalmic diseases. The most important applications of MRI in ophthalmology are orbital and ocular tumor diseases. In recent years, MRI has been gradually applied to clinical and scientific research of visual impairment. The purpose of this paper is to introduce the applications of MRI in the field of ametropia, cataract, glaucoma, amblyopia, optic nerve diseases, choroidal disease, retinopathy, and so on.

Abstract:With cataract surgery become commonly performed, to pursue efficiency of the surgery, ophthalmologists prefer to increase vacuum during phacoemulsification. High vacuum can cause the instability of the anterior chamber, requiring increased infusion pressure to maintain the stability. However, high infusion pressure can affect the structure and function of the retina. This article reviews the studies of effect of infusion pressure during cataract surgery on retinal structure and function.

Abstract:Incidence rate of diabetes mellitus(DM)rises up obviously around the world. This disease can cause diabetic retinopathy, diabetic keratopathy, cataract, glaucoma, refractive changes, iridociliary disorder, dry eyes and other ophthalmic complications, which severely affect vision and even result in blindness. In recent years, with improvement of life quality, it is gradually frequent for diabetics to see ophthalmologist on account of sore eyes. This phenomenon has attracted attention of oculists, which is related to abnormal factors such as abnormal tear quality and quantity under diabetes condition, poor stability of tear film, rising of tear osmotic pressure, inflammatory response, cornea neurodegeneration, apoptosis, functional lesion of tarsus related to sex hormone. As over 90% of diabetics are diagnosed as type 2 diabetes mellitus(T2DM), this paper will summarize pathogenesis of dry eyes related to T2DM and offer theoretical foundation to clinical diagnosis and treatment.

Abstract:Amblyopia is a common disease in the process of childhood development. Early detection, early treatment and rational application of treatment are the keys to amblyopia treatment. At present, the main treatment methods used in clinical practice include refractive correction, suppression therapy, visual perception training, binocular training, and Chinese medicine treatment. After the development of these treatment methods, the current situation and future development trends deserve to be discussed in depth. Based on the review of relevant literature at home and abroad, the author makes a review of the treatment of amblyopia and its latest progress.

Abstract:AIM: To study the serum lipids changes in patients with Leber congenital amaurosis(LCA).

METHODS: Based on the retrospective study and the simple size in the statistics, 50 cases of LCA patients and 52 cases of normal people were included. The serum levels of low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C), triglycerides(TG), and total cholesterol(TC)were measured by professionals in hospital according to the single blind study. Data were analyzed statistically between the LCA group and normal group.

RESULTS: Among the 50 patients with LCA, abnormal serum lipid content accounted for 46%, of which 26% were low in HDL-C levels, hypertriglyceridemia accounted for 48%, hypercholesteremia accounted for 17%, respectively, 9% of patients had mixed hyperlipidaemia. The serum level of HDL-C was 1.221±0.317mmol/L in the LCA group, which was significantly lower than the normal group(P<0.05). The serum levels of TG and TC were 1.377±1.171mmol/L and 4.506±0.694mmol/L in the LCA group, which were significantly higher than the normal group(all P<0.01). There was no significant difference in the serum level of LDL-C between LCA and normal group(P>0.05).

CONCLUSION: In patients with LCA, abnormal concentration changes of HDL-C,TG and TC may be associated with the occurrence of LCA.

Abstract:AIM: To investigate the effect of silicone hydrogel soft contact lens in the treatment of persistent corneal epithelial defect.

METHODS: The clinical data of 56 patients(56 eyes)with persistent corneal epithelial defect treated in our hospital from January 2014 to January 2017 were retrospectively analyzed; 21 patients in the control group received hydrogel contact lenses, and 35 patients in the observation group received silicone hydrogel soft contact lens. Then the clinical effect, the classification of corneal opacity, the improvement of visual acuity, the subjective comfort and complications of the patients were recorded.

RESULTS: Wilcoxon rank sum test showed that there were significant differences in the clinical efficacy between the two groups(P=0.042). The total effective rate of the observation group was significantly lower than that of the control group(94% vs 76%). There was no significant difference in Haze classification between the groups after 3d of treatment(P>0.05); after 1wk and 1mo of treatment, there were significant differences in Haze classification between groups(P<0.05); after 1mo of treatment, the proportion of Haze grading 0 in the observation group was significantly higher than that in the control group(49% vs 19%), there was significant difference between the two groups(χ²=4.481, P=0.027). There was a significant difference in visual acuity between the two groups(Z=-3.347, P<0.05); the visual acuity of 91.43% in the observation group were improved, which was significantly lower than that of the control group(52.38%, P=0.002). There was no significant difference in the comfort scores between the two groups before treatment(P>0.05). After the first day of treatment, the comfort scores of both groups increased. The comfort scores of the observation group after treatment 1d, 3d and 1wk were significantly lower than those of the control group(t=-17.422, -15.827, -16.588; P<0.01). The average healing time of corneal epithelium in the observation group was 4.25±1.05d, and the control group was 5.96±2.16d(t=-3.395, P<0.05). The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).

CONCLUSION: Silicon hydrogel soft corneal contact lens can be used in the treatment of persistent corneal epithelial defect.

Abstract:AIM:To investigate the correlation of serum miR-146a with nuclear factor-κB(NF-κB)and vascular endothelial growth factor(VEGF)in diabetic retinopathy patients.

METHODS: A total of 100 patients with T2DM treated in our hospital from July 2016 to December 2017 were assigned into T2DM patients with DR(DR group, n=32)and T2DM patients without DR(T2DM group, n=68). Thirty healthy volunteers were selected as control group. Real-time PCR was used to examine the expression of miR-146a. Enzyme linked immunosorbent assay was used to detect the levels of NF-κB and VEGF. The correlation between miR-146a and NF-κB and VEGF was analyzed.

RESULTS: Compared with the control group, HbA1c in T2DM group and DR group increased(t=6.822, 5.709; P<0.001), FBG increased(t=8.889, 7.923; P<0.001), 2hPBG increased(t=6.646, 5.514; P<0.001). Compared with T2DM group, the duration of diabetes in DR group was longer(t=2.431, P=0.017). Compared with the control group, serum miR-146a in T2DM and group DR significantly decreased(t=3.967, 7.169; P<0.001), and the DR group was lower than that in the T2DM group(t=4.444, P<0.001). Compared with the control group, the serum NF-κB in the T2DM and DR group increased significantly(t=6.063, 14.851; P<0.001), VEGF increased significantly(t=7.613, 12.943; P<0.001), NF-κB and VEGF in DR group were larger than those in T2DM group(t=11.406, 7.560; P<0.001). Pearson analysis showed that miR-146a was negatively correlated with NF-κB and VEGF(r=-0.503, -0.574; P<0.05).

CONCLUSION: The serum miR-146a in DR patients significantly decreased, the NF-κB and VEGF significantly increased. MiR-146a may be involved in the pathogenesis of DR by mediating inflammatory reaction and vascular proliferation.

Abstract:AIM:To explore the effects of Conbercept combined with laser on inflammatory factors, oxidative stress levels and retinal hemodynamics in diabetic retinopathy.

METHODS: One hundred patients with diabetic retinopathy who were diagnosed and treated in our hospital from October 2015 to February 2017 were randomly divided into control group and observation group, 50 cases in each group. The control group was given laser treatment. The observation group was treated with conbercept on the basis of the control group. Afterwards, the clinical efficacy, inflammatory factors, oxidative stress and retinal hemodynamic level were tested before and after treatment of two groups of patients.

RESULTS: There was no significant difference in LogMAR value and retinal thickness between the two groups before treatment(P>0.05). After treatment, both LogMAR values of visual acuity and retinal thickness decreased significantly in the two groups. After treatment, the LogMAR value of visual acuity of the observation group was 0.65±0.05, the thickness of retina was 157.97±15.51μm, which was significantly lower than that of the control group(P<0.05). After treatment, the levels of IL-1β, IL-6 and IL-8 in serum were significantly lower than those before treatment. The levels of IL-1β, IL-6 and IL-8 of the observation group were 16.93±0.48ng/L, 92.22±1.03pg/mL and 0.33±0.06ng/L respectively, which were significantly lower than those of the control group after treatment(P<0.05). The levels of MDA, LHP and ROS in the two groups significantly decreased after treatment, and the levels of MDA, LHP and ROS in the observation group were 4.16±0.21μmol/L, 164.97±6.51μmol/L and 261.15±14.44μmol/L, which was significantly lower than that of the control group after treatment(P<0.05). After treatment, PSV and EDV levels in both groups significantly increased, and RI levels significantly decreased. The levels of PSV and EDV in the observation group were 9.59±0.22cm/s and 2.96±0.05cm/s, respectively, which were significantly higher than those in the control group. The RI level in the control group was 0.66±0.04, which was significantly lower than that in the control group(P<0.05).

CONCLUSION: Conbercept combined with laser can effectively improve the vision of patients with retinopathy, reduce retinal thickness, reduce the levels of inflammatory cytokines and oxidative stress, and improve retinal hemodynamics. The curative effect is reliable.

Abstract:AIM: To observe the efficacy of ω-3 polyunsaturated fatty acids in patients with age-related macular degeneration(ARMD)after receiving a poor response to the combination of ranibizumab and photodynamic therapy(PDT).

METHODS: Ninety-two cases(122 eyes)of patients with age-related macular degeneration in our hospital from February 2015 to January 2017 were selected as the subjects. All patients were given intravitreal ranibizumab injection combined with photodynamic therapy, according to the received light sensitive dose were randomly divided into half dose group(45 eyes of 60 cases)and full dose group(47 eyes of 62 cases), half dose group received half dose verteporfin(3mg/m²), the full dose group received full dose verteporfin(6mg/m²). The patients were followed up for 1mo, 3mo after treatment. After 3mo treatment, 41 eyes of 30 patients paitents who got choroidal neovascularization(CNV)leakage again or leakage increased were randomly divided into control group of 14 cases(20 eyes), experimental group of 16 cases(21 eyes). All patients were treated with ranibizumab combined with half dose verteporfin(3mg/m²), photodynamic therapy. The experimental group were added with ω-3 polyunsaturated fatty acids soft capsule(twice per day, 1 tablets per time, period of 6mo). All patients were followed up at 1, 3 and 6mo after treatment.best corrected visual acuity(BCVA), central macular retinal thick(CRT), intraocular pressure, total effective rate of CNV, the average number of injections of ranibizumab and adverse reactions were observed during the follwed up.

RESULTS: The BCVA, CRT, intraocular pressure before and after 1,3mo treatment and the total efficiency of CNV of half dose group were no statistical differences with the full dose group(P>0.05). The number of times ranibizumab injection of half dose group(1.1±0.8, 1.6±1.2)were lower than that in the full dose group(1.6±1.1, 2.5±1.7)at 1 and 3mo after treatment, the differences were statistically significant(P<0.05). The BCVA and CNV in experimental group was higher, CRT and ranibizumab injection times were lower than that in the control group at 1,3 and 6mo after treatment, the differences were statistically significant(P<0.05). No serious adverse reactions related treatment were occurred in all patients.

CONCLUSION: It is safe and effective to treat patients with age-related macular degeneration by ranibizumab combined with half dose photodynamic therapy. The combination of ω-3 polyunsaturated fatty acids can improve the therapeutic effect.

Abstract:AIM: To compare the efficacy between Ranibizumab and Conbercept for wet age-related macular degeneration.

METHODS: Totally 78 cases(78 eyes)of wet age-related macular degeneration treated in our hospital from February 2014 to March 2016 were selected and divided into Group A and Group B, each with 39 cases(39 eyes). Patients in two groups were given ranibizumab and conbercept respectively, and were followed up for 12mo. The various data including visual acuity, the macular foveal retinal thickness, choroidal neovascularization(CNV)leakage and complications were compares between two groups.

RESULTS: At 1wk, 1 and 3mo after treatment, the uncorrected vision of Group A was higher than that of Group B, the difference was statistical significance(t=14.05, 12.71, 18.27; P<0.05). The macular foveal retinal thickness at different time points in Group A was thinner than that of Group B, the difference held statistical meaning(t=13.04, 12.17, 18.19; P<0.05). Two groups' total efficiency at 1 and 3mo after operation had no statistical points(χ²=1.076, 0.253; P>0.05).

CONCLUSION: The ranibizumab and conbercept shows identical effect in treating CNV leakage of patients wet age-related macular degeneration without any serious complications occurred, but the comparison of the two shows that the improvements of visual acuity and macular foveal retinal thickness are better in ranibizumab treatment than in conbercept treatment.

Abstract:AIM: To investigate the clinical efficacy of Ranibizumab combined with laser photocoagulation in the treatment of diabetic macular edema(DME).

METHODS: The clinical data of 190 patients(190 eyes)with DME treated in our hospital from June 2014 to June 2016 were retrospectively analyzed; 90 patients(90 eyes)received intravitreal ranibizumab injections were included into control group, and 100 patients(100 eyes)received the combination of intravitreal ranibizumab injections and laser photocoagulation were included into observation group. The best corrected visual acuity(BCVA)between the two groups before and after operation was compared. The central macular thickness(CMT)and the leakage of macular edema of the two groups were measured by the optical coherence tomography(OCT)and fundus fluorescein angiography(FFA)respectively. The number of drug injection between the two groups was recorded. Then patients were followed up and the incidence of the complications was recorded. All the patients were followed up for 12mo.

RESULTS: The average BCVA scores in the observation group after operation were significantly higher than those before operation. The preoperative average BCVA scores in the control group were lower than those at 1, 3, 6 and 12mo after operation. The difference between the two groups was statistically significant at 6 and 12mo after treatment(P<0.05), and there was no statistically significant difference at 1 and 3mo after treatment(P>0.05). CMT significantly decreased in both groups after treatment. CMT of the observation group was significantly thinner than that of the control group after 1, 3, 6 and 12mo treatments, the difference was statistically significant(P<0.05). In the last follow-up, the no macular edema leakage rate of the observation group was 45.0%, which was significantly higher than that of the control group(30.0%), the difference was statistically significant(P<0.05). The number of drug injection in the observation group was significantly lower than that in the control group, the difference was statistically significant(P<0.05), and there was no obvious complication in the two groups after the operation.

CONCLUSION: Compared with ranibizumab treatment alone, the combination of laser photocoagulation has better long-term vision improvement and better reduction of CMT. The combination treatment can also improve the condition of macular edema with less number of drug injection.

Abstract:AIM:To investigate the clinical efficacy of retrobulbar or intravitreal injection of triamcinolone acetonide combined with 532nm laser photocoagulation in the treatment of diabetic macular edema(DME).

METHODS: Sixty-two eyes in 40 DME patients were divided into two groups(Group A and Group B)randomly. Thirty-one eyes in Group A were treated with retrobulbar injection of triamcinolone acetonide(RBTA)and 31 eyes in Group B were treated with intravitreous injection of triamcinolone acetonide(IVTA). Eyes with limited macular edema were treated by local direct retinal laser, those with diffuse and cystic macular edema were treated by grid retinal laser using Vitra 532nm fundus lasers at 1mo after injection. Visual acuity, intraocular pressure, fundus, macular edema and complications were recorded after 1wk, 1, 3 and 6mo in the follow-up study.

RESULTS: The mean best corrected visual acuity was improved and macular edema subsided after treatment in the two groups in the follow-up study at 1wk, 1, 3 and 6mo(P<0.05), while there had no significant difference between groups(P>0.05). In Group A, significant efficiency rate was 39%(12/31), total effective rate was 90%(28/31). In Group B, significant efficiency rate was 39%(12/31), total effective rate was 94%(29/31). The follow-up study showed no retinal detachment, endophthalmitis, intraocular hemorrhage and other complications.

CONCLUSION: Triamcinolone acetonide injection combined with laser photocoagulation is an effective method for treatment of DME with significant effect, less adverse reactions, patient's vision improved effectively and macular edema reduced. No significant difference was noted in the treatment of DME between RBTA and IVTA.

Abstract:AIM: To analyze the vision distribution and its related risk factors of two teenager aviation schools in Western China.

METHODS: The study was a cross-sectional survey. A total of 233 participants were randomly selected from two teenager aviation schools in Western China in November and December of 2017, which were all qualified through the standard of physical examination by Air Force. Distance visual acuity of students was checked and questionnaires about influencing factors of vision were filled voluntarily. Mann-Whitney U rank-sum test and chi-square test were applied for single factor analysis, and Multiple factor Logistic regression analysis was used for the main influence factors of the vision difference.

RESULTS: The proportion of students with less than 0.8 eyesight in school B of Grade 2 and Grade 3 were 18.6% and 45.9%, which was significantly higher than that of 2.6% and 20% of school A. The well-vision distribution in school B of Grade 2 and Grade 3 were lower than that of school A(P<0.05). Single factor analysis showed that school reading and writing time in school B of Grade 2(360min, average: 180-535min)and Grade 3(470min, average: 440-500min)were higher than that of school A(Greade 2: 200min, average: 180-315min; Grade 3: 440min, average: 400-480min; P<0.05); and outdoor activity time of the two grades(Grade 2: 420min, average: 325-516min and Grade 3: 378min, average: 265-515min)were lower than that of school A(Grade 2: 510min, average: 439-681min and Grade 3: 440min, average: 370-601min; P<0.05), and the proportion of students whose mother had a senior high school degree or above in school B was lower than that of school A(P=0.032). Multiple factor Logistic regression analysis showed that reading and writing time was a risk factor for vision loss(OR=1.109, P=0.010)and outdoor activity time was a protective factor(OR=0.986, P=0.001). Mothers' education background, father's educational background, parents' myopia, primary school enrollment age, class time and electronic product using time were not the main factors affecting the vision.

CONCLUSION: More reading and writing time and less outdoor activity time are the main factors for loss of vision, the key point of school myopia prevention needs to coordinate the time between reading, writing and outdoor activity.

Abstract:AIM: To explore the posterior corneal surface height after femtosecond laser small incision lenticule extraction(SMILE)or femtosecond laser in situ keratomileusis surgery(Fs-LASIK).

METHODS: A retrospective analysis of 113 cases of patients(226 eyes)with myopia underwent laser corneal refractive surgery in our hospital from January to December 2016 was taken. There were 51 cases(102 eyes)with SMILE and 62(124 eyes)with Fs-LASIK. Postoperative posterior corneal surface height, uncorrected visual acuity, spherical equivalent change, operation safety were analyzed and compared between the two groups.

RESULTS: The preoperative posterior corneal surface height had no statistical difference between the two groups(P>0.05). Corneal surface height at 1, 3 and 6mo after operation were significantly higher than those before operation(P<0.05), but the differences between the two groups at different time points after operation were not significant(P>0.05). Preoperative uncorrected visual acuity had no statistical difference between the two groups(P>0.05); postoperative uncorrected visual acuity at 1, 3 and 6mo were significantly better than those before operation(P<0.05), but the differences between the two groups at different time points after operation were not significant(P>0.05). Preoperative spherical equivalent had no statistical difference between the two groups(P>0.05); postoperative spherical equivalent at 1wk were significantly better than those before operation(P<0.05), but the differences between the two groups after operation were not significant(P>0.05). Postoperative incidence of adverse reactions such as corneal edema, corneal infection, diffuse lamellar keratitis and postoperative glare had no statistical difference between the two groups at 6mo after operation(P>0.05).

CONCLUSION: SMILE and Fs-LASIK can be safely and effectively correcting visual acuity, but posterior corneal surface partial forward occurred after either operation.

Abstract:AIM:To investigate the effects of laser in situ keratomileusis(LASIK)on ocular surface by femtosecond laser or mechanical microkeratome for creating corneal flap, and to study the effect of different corneal flap method on ocular surface after operation.

METHODS: This study included 218 cases(436 eyes)myopia patients from January 2016 to January 2017 in our hospital for refractive surgery, their medical records were retrospectively analyzed. They all underwent LASIK surgery treatment and complained of different degree of dry eye postoperatively, foreign body sensation and discomfort. Mechanical microkeratome was used in 61 cases(122 eyes)of patients and they were as control group, with femtosecond laser, 157 cases(314 eyes)were set as observation group. We compared dry eye symptom scores, corneal fluorescein staining(FL)score, break-up time(BUT)and basic tear secretion test(SⅠt)between the two groups preoperatively and postoperatively 1wk, 1, and 3mo.

RESULTS: Before surgery, dry eye symptoms scoring of two groups had no statistically significant difference(P>0.05); the scores of the two groups were significantly different before and after surgery(P<0.05); postoperatively 1wk, dry eye symptoms score of control group was greater than that of the observation group with significant difference(P<0.05), the sores at 1 and 3mo after surgery were not different between the two groups(P>0.05). There was no significant differenc on the preoperative BUT between the two groups(P>0.05). BUT before and after surgery was significantly different of both groups(P<0.05). BUT of control group was significantly lower than that of observation group postoperatively(P<0.05). Before surgery, FL score of two groups had no statistically significant difference(P>0.05); the scores of the two groups were significantly different before and after surgery(P<0.05); postoperatively 1wk and 1mo, FL score of control group was greater than that of the observation group with significant difference(P<0.05), the sores at 3mo after surgery were not different between the two groups(P>0.05). Before surgery, SⅠt of two groups had no statistically significant difference(P>0.05); the scores of the two groups were significantly different before and after surgery(P<0.05); postoperatively 1wk and 1mo, SⅠt of control group was lower than that of the observation group with significant difference(P<0.05); SⅠt at 3mo after surgery were not different between the two groups(P>0.05). Two groups of patients had no serious postoperative complications occurred.

CONCLUSION: Compared with the mechanical microkeratome for creating corneal flap, LASIK with femtosecond laser for creating corneal flap has less effect on ocular surface and has mild symptoms of dry eye, the effect time is also shortened.

Abstract:AIM:To evaluate the effect of monocular rectus surgery for adult sensory exotropia.

METHODS: Totally 76 cases of adult sensory exotropia of degree -15^△ to -160^△(-68.36^△±30.77^△)examined through Krimsky method were included into this study. A total of 16 cases, 37 cases and 23 cases with different degrees of strabismus were treated separately with routine amount monocular lateral rectus recession, routine amount monocular medial rectus resection plus lateral rectus recession, and exceed constant amount monocular medial rectus resection plus lateral rectus recession. Follow-up was performed at 1d, 1wk, 1, 3 and 6mo after operation. The eye position, monocular movement, intraocular pressure(IOP), slit lamp, and fundus of these patients were examined.

RESULTS:After surgery, 67 cases(88%)were positive and 9 cases(12%)were undercorrection. The postoperative intraocular pressure of operative eye at 1wk was equal to preoperative(P=0.090), and IOP decreased to a valley value at 1mo(P<0.01), there was no significant difference in intraocular pressure between 3mo and 1mo(P=0.092), and no significant difference in intraocular pressure between 6mo and 3mo(P=0.123). And 2 cases(3%)had inflammatory reaction induced by anterior segment ischemia at 1d and 1wk postoperative visits, and they recovered at 1mo follow-up visit; 4 cases(5%)experienced an external dysfunction at the 1, 3 and 6mo follow-up.

CONCLUSION:Monocular rectus surgery has a good therapeutic effect on adult patients with sensory exotropia; the decrease in intraocular pressure secondary to the detached rectus is worth the attention of the surgeon; the incidence of complications after detaching monocular of two rectus muscles is comparable low. Exceed constant amount rectus strabismus surgery for sensory exotropia may result in limited function of postoperative ocular hyperextension.

Abstract:AIM: To study the myopia and influencing factors among primary school students in Haidian, Beijing.

METHODS: A total of 801 primary school pupils from grade one to grade three of Beijing were selected according to the cluster stratified sampling method, and 801 questionnaires were collected from the scene, which accorded with 757 people aged 7-10 years old, and 757 valid questionnaires, the prevalence rate of this study was 24.4%. The baseline data of all the subjects were collected through questionnaires. The data of myopia were compared. The Logistic regression equation was used to calculate the factors causing myopia.

RESULTS: The main factors leading to myopia in primary school were reading time, electronic product use time, parents' myopia, outdoor activity time, and reading and writing postures. The above difference data was brought into the Logistic regression equation to confirm.

CONCLUSION: The myopia rate of primary school students in Beijing has reached a high level. There are many problems in family, daily life and students themselves. It is necessary to prevent and control the occurrence of myopia and promote the vision health of primary school students.

Abstract:AIM: To determine the lowest concentration of trypan blue(TB)used to stain the anterior capsule satisfactorily and to evaluate the clinical significance of trypan-blue-assisted capsulorhexis in cataract surgery.

METHODS:Totally 60 cases(60 eyes)of mature age-related cataract, of which the cortex lentis cloudy degree was C4-C5 and the nucleus of the lens was N3, were randomly divided into three groups. Different concentrations of TB, 0.03%, 0.015%, 0.0075%, were used in staining groups respectively to stain the anterior capsule during cataract surgery. All cases were performed with manual small-incision cataract surgery by the same ophthalmologist. The staining effects, the success rate of continuous circular capsulorrhexis(CCC), the posterior capsule rupture and the state of the intraocular lens(IOL)were studied during the operation. The significant statistics was conducted between the groups. The density of corneal endothelial cells, intraocular pressure(IOP), inflammation in anterior chamber, corneal edema, staining of other intraocular structures were also observed at 1d, 1wk, 3mo postoperatively.

RESULTS: Trypan blue in concentrations as low as 0.015% stained the anterior capsule satisfactorily, allowing safe creation of a CCC. At concentrations of 0.03% and 0.015%, the success rate of CCC and the state of the intraocular lens(IOL)was significantly better than 0.0075% group, the difference was statistically significant(P<0.0083). The difference of posterior capsule rupture rates and the rate of lost corneal endothelial cells in three groups were not statistically significant(P>0.0083). The staining of CCC margin and side port disappeared in 1wk after surgery. Inflammation in anterior chamber of all cases was slight. There was not any evidence of residual stain in the anterior segment during the postoperative period. There was no corneal edema and intraocular pressure higher after 1wk.

CONCLUSION: Trypan blue staining of the anterior capsule is a safe and useful technique in cataract surgery, which can raise the success rate of cataract surgery. The 0.015% trypan blue staining, the lowest effective concentration, is strongly considered.

Abstract:AIM: To compare the refraction error(RE)3mo after phacoemulsification combined with intraocular lens implantation(PHACO+IOL)between patients with acute primary angle-closure glaucoma(APACG)with cataract(APACG group)and patients with simple cataract(cataract group), and the biological parameters of the eye(axial length,corneal curvature, anterior chamber depth)associated with the postoperative RE in the APACG and cataract groups.

METHODS: This was a prospective, non-randomized, case-control study. Each group had 30 cases(30 eyes). Intraocular pressure, axial length, corneal curvature, and anterior chamber depth were measured. The reserved refractive power was calculated using the SRK-II formula. Three months postoperatively, subjective RE was calculated as the postoperative refractive power which subtracted the preoperative reserved diopter(RE was considered as <-0.50D or >+0.50D; -0.50D to +0.50D not considered as RE). An independent sample t-test was used to compare the difference in RE between the two groups and to compare the differences among relevant parameters such as axial length, corneal curvature, and anterior chamber depth. Paired t-test was used to compare preoperative and postoperative parameters such as axial length, corneal curvature, and difference in anterior chamber depth.

RESULTS: Mean RE in the cataract group was -0.46D±0.46D, with 24 cases of myopic RE(80%)and 6 cases of hyperopic RE(20%). Mean RE in the APACG group was +0.56D±0.79D, with 9 cases of myopic RE(30%)and 21 cases of hyperopic RE(70%). The difference in RE between the two groups was statistically significant(P<0.05). On comparison of pre- and postoperative biological parameters of the two groups, in the cataract group, there was a non-significant difference in pre- and postoperative axial length(23.55±0.47mm versus 23.56±0.48mm, respectively; P>0.05). In the APACG group, pre- and postoperative axial length was 21.71±0.46mm and 21.52±0.54mm, respectively; the difference was statistically significant(P<0.05). In the both the cataract and APACG groups, postoperative anterior chamber depth was significantly higher than preoperative(4.09±0.38mm versus 2.71±0.24mm, in the cataract group, and 3.55±0.35mm versus 1.90±0.23mm, In the APACG group, respectively; both P<0.05). In the cataract group and the APACG groups, pre- and postoperative average corneal curvature were not significantly different(43.93D±0.95D versus 43.92D±0.95D, in the cataract group, and 44.71D±0.84D versus 44.70D±0.9D, In the APACG group, respectively; P>0.05). On comparison of biological parameters between the two groups, postoperative ocular axial length shortening in the APACG group was statistically significant compared with the ocular axial changes in the cataract group(P<0.05). The postoperative anterior chamber deepened markedly in the APACG group; this was statistically significant compared with the cataract group(P<0.05).

CONCLUSION:Postoperative RE in patients with APACG and cataract who underwent PHACO+IOL is relatively large compared with patients with simple cataracts. These patients with APACG and cataract also show hyperopia drift, which is more significantly correlated with postoperative ocular axial length shortening and increased anterior chamber depth.

Abstract:AIM: To evaluate the clinical efficacy and safety of transscleral cyclophotocoagulation(TSCP)for glaucoma secondary to vitrectomy.

METHODS: A retrospective review was performed within 20 patients(20 eyes)with glaucoma secondary to vitrectomy underwent TSCP in our hospital from October 2014 to October 2016. The follow-up time was 3mo. The postoperative visual acuity, intraocular pressure(IOP)and complications were observed.

RESULTS: One month after operation, the postoperative IOP increased in 9 cases. Another 4 eyes were performed TSCP again, and three of them got the normal IOP recovery. At the last follow-up, visual acuity had no significant changes(P=0.655); IOP was effectively controlled in 14(70%)patients. Meanwhile, the mean postoperative IOP(24.6±11.4mmHg)was statistically reduced than the mean preoperative IOP(42.3±5.9mmHg, P<0.05). No serious complications, like hypotony and suprachoroidal hemorrhage, had been observed during 3-month follow-up.

CONCLUSION: TSCP procedure is a safe, effective, repeatable surgery for patients with glaucoma secondary to vitrectomy.

Abstract:AIM: To investigate the correlation between glycosylated hemoglobin(HbA1c)level and macular fovea retinal thickness after cataract surgery in diabetic patients.

METHODS: By a randomized sampling and retrospective study, from September 2013 to June 2016, a total of 119 cases(119 eyes)of diabetic retinopathy in our hospital were selected and divided into low HbA1c group(HbA1c≤7.0%)of 60 cases(60 eyes)and high HbA1c group(7.0%RESULTS: At preoperative 1d, HbA1c in the high HbA1c group and the low HbA1c group were 8.29%±2.19% and 5.38%±1.49% respectively, and the differences between two groups were statistically significant(P<0.05); macular foveal retinal thickness in the 5 regions of high HbA1c group were significantly higher than that in the low HbA1c group(P<0.05). At postoperative 7d of macular fovea retinal thickness in the 5 regions of the two groups was higher than that at postoperative 1d(P<0.05), and the high HbA1c group was also significantly higher than that of the low HbA1c group(P<0.05). Linear regression analysis showed that preoperative 1d HbA1c were significant positive correlation with preoperative 1d, postoperative 7d of macular foveal retinal thickness in 5 regions(P<0.05).

CONCLUSION: HbA1c levels in diabetic patients are significantly correlated with preoperative and postoperative macular foveal retinal thickness. It has important clinical significance for monitoring the occurrence and development of macular edema after cataract surgery.

Abstract:AIM: To measure the posterior pole retinal thickness and retinal nerve fiber layer(RNFL)thickness using the Heidelberg spectral domain optical coherence(SD-OCT), and explore the correlation between age, refraction diopter and retinal thickness.

METHODS: A total of 192 eyes of 96 healthy children with the age from 5 to 15 years old were examined by routine ophthalmic examinations. The SD-OCT of Spectralis Heidelberg was used to examine the thickness of the posterior retina and optic nerve fibers of the subjects within 20° and this district was divided to superior and inferior by the line collecting optic disc and macula. The detection was taken within the area of 1mm away the macular fovea. The correlation between age, refraction diopter and change of retinal morphology were analyzed.

RESULTS: The average thickness of the retina around 1mm area from the fovea was 252.72±13.87μm, the mean posterior pole retinal thickness(PPRT)was 294.02±8.70μm, the superior PPRT was 294.53±9.11μm, the inferior PPRT was 293.53±9.50μm, and the average RNFL thickness was 105.75±10.60μm. There were positive correlation between age and PPRT, and positive correlation between diopter, PPRT and RNFL thickness.

CONCLUSION: SD-OCT can accurately measure the thickness of children's retina, and there is a correlation between age, refractive diopter and retinal thickness.

Abstract:AIM:To investigate the risk factors of diabetic retinopathy in type 2 diabetic patients.

METHODS: The data of 1 013 patients with type 2 diabetes mellitus who admitted to hospital from January 2013 to April 2017 were retrospectively analyzed. Diabetic retinopathy patients were included in the observation group, and non diabetic retinopathy patients were included in the control group. Then the risk factors of diabetic retinopathy in type 2 diabetic patients were analyzed.

RESULTS: After investigation, the incidence of DR was 27.74%(281/1013). By univariate analysis, the differences of gender, age, duration of T2DM, blood pressure, HbA1c, HDL-C, creatinine and 24h urine protein between the two groups were statistically significant(P<0.05). Multivariate Logistic regression analysis showed that men, age more than 60 years, T2DM duration of more than 10a, and blood pressure, HbA1c, HDL-C, creatinine, and abnormal expression of 24h urinary protein were risk factors for DR in type 2 diabetes mellitus patients(P<0.05).

CONCLUSION: At present, the risk of DR in patients with type 2 diabetes is also higher. Men, age more than 60 years, T2DM duration of more than 10a, and blood pressure, HbA1c, HDL-C, creatinine, and abnormal expression of 24h urinary protein are risk factors for DR in type 2 diabetes mellitus patients.

Abstract:AIM: To discuss the treatment and to evaluate the therapeutic effect by reviewing a group of postvitrectomy diabetic vitreous haemorrhage(PDVH)cases after vitrectomy for proliferative diabetic retinopathy(PDR).

METHODS: Retrospective analysis of 12 cases of 12 PDR patients with PDVH in our hospital from September 2015 to June 2017. First, conservative treatment was performed and then surgical treatments were performed on patients with large amount of bleeding and poor effect of conservative treatment(including anterior chamber flushing, vitreous lavage, vitrectomy, or combination of cataract surgery). The patients were observed and analyzed during and after surgeries.

RESULTS: The mean duration between the first surgery and PDVH ranged from 1d to 10mo(mean 61.58±92.69d). The cases of early and late PDVH was 8 eyes and 4 eyes, respectively. Two eyes were treated with conservative treatment and the bleeding were absorbed after 2wk-1mo. Ten eyes without obvious improvement after treatment or intraocular pressure(IOP)increased again received surgical treatment, in which 2 eyes were treated with simple anterior chamber flushing, 8 eyes underwent vitreous lavage(2 eyes combined with cataract surgery, 1 eyes combined with silicone oil injection). Seven eyes received supplementary photocoagulation. Till the last follow-up, all vitreous haemorrhages resolved, and 9 eyes had better visual acuity.

CONCLUSION: PDVH can be induced by various reasons and appropriate measures should be taken by regulating blood glucose, improving operative skills and timely symptomatic treatments to improve the visual acuity.

Abstract:AIM: To investigate the clinical efficacy of 23G /25G minimally invasive vitrectomy assisted by intravitreal injection of Ranibizumab(IVR)in the treatment of severe proliferative diabetic retinopathy(PDR).

METHODS: The respective analysis of 56 eyes of 56 patients with severe PDR treated by minimally invasive vitrectomy from June 2014 to July 2016 was performed. Thirty eyes treated by IVR-assisted minimally invasive vitrectomy as Group A and 26 eyes treated by minimally invasive vitrectomy only as Group B. IVR(0.5mg/0.05mL)was performed on the eyes 5-7d before PPV in Group A. Operative duration, hemorrhage during the operation, endodiathermy times, incidence of iatrogenic retinal holes and best corrected visual acuity(BCVA)between the two groups were observed. The follow-up period was 6mo.

RESULTS: The average operation time in Group A was 98.10 ± 14.23min, Group B was 113.89±17.66min, the difference was statistically significant(t=3.703, P=0.0005). Hemorrhage during the operation was observed in 6 eyes in Group A(20%)and 14 eyes in Group B(54%), the difference was statistically significant(χ²=6.95, P=0.0084). Endodiathermy time in Group A was significantly less than in Group B(1.30±1.15 vs 2.73±1.71; t=3.72, P=0.001). The incidence of iatrogenic retinal holes was observed in 2 eyes in Group A(7%)and 7 eyes in Group B(27%). The difference was statistically significant(χ²=4.24, P=0.0396)in the two groups. The BCVA at post-operation 1mo was significantly improved in comparison with pre-operation, but no significant difference in the post-operative BCVA between the two groups(87% vs 73%; χ²=1.630, P=0.202).

CONCLUSION: Minimally invasive vitrectomy assisted with the preoperative intravitreal injection of ranibizumab in the treatment of severe PDR can effectively shorten the operation time, lessen the incidence of hemorrhage, endodiathermy time and iatrogenic retinal holes. No significant difference in the post-operative BCVA between the two groups.

Abstract:AIM: To study the postoperative incidence and related factors of high intraocular pressure after vitrectomy in patients with proliferative diabetic retinopathy(PDR).

METHODS: Selected in February 2014 to February 2016, 110 cases(160 eyes)of PDR patients were retrospectively analyzed; postoperative vision improvement, high intraocular pressure in patients with different stages of PDR were analyzed and related factors were detected.

RESULTS: Postoperative vision of PDR patients with stage Ⅳ, stage Ⅴ, and stage Ⅵ significantly improved(P<0.01). A total of 47 eyes had high intraocular pressure, in which there were 7 eyes during 1-2mo after operation, 12 eye during 3-4mo, 13 eyes during 5-6mo and, 7 eyes during 7-8mo, 5 eyes during 9-10mo, 3 eyes during 11-12mo, the total incidence was 29.4%. There 21 eyes(44.7%)had controlled IOP after treatment with conventional drugs; IOP of 6 eyes(12.8%)with peripheral iridectomy for recommunication between anterior and posterior chamber returned to normal; IOP of 7 eyes(14.9%)returned to normal after releasing some gas; IOP of 6 eyes(12.8%)returned to normal after taking out some silicone oil; 7 eyes(14.9%)with surgical resection and local glucocorticoid hormone. Preoperative PDR staging, whether preoperative combined with retinal detachment, whether combined with intraoperative lens removal, whether with intraoperative intraocular filling, whether pan retinal photocoagulation were factors associated with postoperative high intraocular pressure(P<0.05). After multiariable Logistic regression analysis, with retinal detachment and intraoperative intraocular filling was independent risk factors for high intraocular pressure after vitrectomy(P<0.05).

CONCLUSION: Retinal detachment, intraoperative joint lens removal, intraoperative intraocular filling, pan retinal photocoagulation is correlated with high intraocular pressure after vitrectomy. Intraoperative joint lens removal, intraoperative intraocular filling and preoperative PDR staging are independent risk factors. In clinical works, standardized and personalized treatment should be given according to the patients' situation trying to avoid the high IOP after vitrectomy.

Abstract:AIM: To investigate the changes of angiogenic factors and vascular endothelial function in patients with hypertensive retinopathy complicating pregnancy, and to analyze the relationship between the relevant factors and the degree of retinopathy.

METHODS: Totally 82 cases of patients with hypertensive retinopathy in pregnancy were selected as the research subjects. According to the Duker-Elder fundus staging criteria, they were divided into stage Ⅰ group(n=42), patients with stage Ⅱ group(n=25)and stage Ⅲ group(n=15), in addition, pregnancy hypertension patients without retinopathy were selected as control group. We compared the levels of angiogenic factors and vascular endothelial function among groups, and analyzed the relationship between the levels of relevant factors and retinopathy.

RESULTS:The levels of vascular endothelial growth factor(VEGF), insulin like growth factors(IGF-1)and endothelin(ET)-1 in the observation group were significantly higher than those in the control group(P<0.01), and the levels were significantly increased with the increase of fundus staging, the difference was statistically significant. The level of NO in the observation group was significantly lower than that of the control group, with the increase of the fundus staging, the level of NO decreased significantly, and the difference was statistically significant(P<0.01). Spearman correlation analysis showed that the degree of pregnancy induced hypertension retinopathy was positively correlated with VEGF, IGF-1 and ET-1, and negatively correlated with NO(P<0.05).

CONCLUSION: There are obvious angiogenic factors disorder and vascular endotheial dysfunction in patients with hypertensive retinopathy of pregnancy, and its level is correlated with the degree of retinopathy.

Abstract:AIM: To evaluate the anatomic parameters, visual function and quality of life(QOL)in patients with age-related macular degeneration(ARMD)who were transferred from Ranibizumab to Conbercept.

METHODS: Twenty patients(29 eyes)with angiogenic ARMD who were treated in our hospital in January 2016 to August 2017 because of the poor therapeutic effect of ranibizumab were selected. The main outcome measures were BCVA, contrast sensitivity(CS), mean changes of central retinal thickness(CRT)and 25 visual function questionnaires(NEI VFQ-25)from baseline to 4mo. The statistical data were analyzed by paired t test to compare the mean values of continuous variables.

RESULTS: At 4mo after treatment, BCVA were significantly improved compared to before treatment(P<0.05). The CRT detected by OCT decreased(P<0.05). CS at different frequency was better than before treatment(P<0.05). NEI VFQ-25 scores were higher than before treatment(P<0.05).

CONCLUSION: In the treatment of age-related macular degeneration with conbercept, the visual function and the quality of life are remarkably improved.

Abstract:AIM: To investigate the macular function of patients with diabetes mellitus(DM)who had no diabetic retinopathy(DR).

METHODS: Totally 140 eyes of 70 subjects with diabetes who had no vision disorders and fundus abnormalities(DM group)and 160 eyes of 80 normal subjects(control group)were examined. In DM group, from 20 to 30 were 8 patients(16 eyes), from 30 to 40 were 18 patients(36 eyes), from 40 to 50 were 24 patients(48 eyes), over 50 were 20 patients(40 eyes). In control group, there were 20 people in each age stages. Retinal imaging and macular microperimetry were measured by MP-l Microperimeter. The mean retinal light sensitivity(MS)in the central 20°, fixation stability and fixation position in the central 2° and 4° were recorded.

RESULTS: With the ages from 20 to 30, the MS of DM group and control group were 15.32±1.82, 19.41±0.32dB; from 30 to 40, the MS were 14.93±2.11, 18.92±0.73dB; from 40 to 50, the MS were 14.55±2.84, 18.21±0.53dB; over 50 years, the MS were 13.21±2.25, 17.14±1.21dB; respectively,the difference was all statistically significant between the two groups with the same age(P>0.05). All subjects were central fixation. Among 160 eyes of control group, fixation was stable in 124 eyes(77.5%), relative unstable in 36 eyes(22.5%); among 140 eyes of DM group, fixation was stable in 109 eyes(77.9%), relative unstable in 31 eyes(22.1%), the difference was statistically significant(χ²=0.00549, P>0.05).

CONCLUSION: The macular function and the MS in the central 20° had been damaged before fundus morphological abnormalities were detected in patients with diabetes. However, compared with control group, the fixation position and fixation stability did not changed significantly in patients with diabetes.

Abstract:AIM:To analyze the expression of vascular endothelial growth factor(VEGF)in vitreous humor of patients with age-related macular degeneration(ARMD)and its relationship with inflammation.

METHODS:Clinical data of 61 patients with ARMD(61 eyes)received treatment at our hospital from September 2016 to September 2017 were analyzed as Group A. And 25 idiopathic macular hole(IMH)patients(25 eyes)were enrolled as Group B. VEGF, IL-6 and IL-10 levels in vitreous humor were tested and compared between the two group.

RESULTS: Group A patients had higher levels of VEGF and IL-6 in vitreous humor than these of Group B patients, the difference were statistically significant(t=32.530, 8.443; P<0.01). The level of IL-10 between the two groups was not significantly different(P>0.05). ROC analysis showed that the VEGF cut-off point value of 460.6pg/mL, as used for the differential diagnosis between ARMD and IMH, provided a sensitivity of 84.00%, a specificity of 93.44%, area under the curve(AUC)was 0.879, better than these of IL-6. Correlation analysis showed that, for Group A patients, the levels of VEGF had significant positive correlation with IL-6(r=0.787, P<0.01).

CONCLUSION: The level of VEGF increased significantly in patients with ARMD and had positive correlation with inflammation, which can be used as an auxiliary diagnosis marker for ARMD from IMH.

Abstract:AIM: To investigate the clinical effect of probing lacrimal passage for congenital dacryocystitis in children.

METHODS: Totally 322 children(361 eyes)with congenital dacryocystitis treated in our hospital from January 2011 to December 2016 were selected and underwent lacrimal duct probing. The follow-up were taken on 1wk, 1 and 3mo after operation.

RESULTS: The cure rate of 322 cases(361 eyes)of congenital dacryocystitis was 99.2%(358 eyes); 3 eyes had nasolacrimal duct bony obstruction, 1 eyes had edema, 11 eyes had bleeding, and no other complications occurred. The success rate of once probing of children between 9 months to 18 months(85.0%, 204 eyes/240 eyes)was significantly higher than that of children older than 18 months(60.2%, 71 eyes/118 eyes), the difference was statistically significant(χ²=27.387, P<0.05). The one-time probing rate of multiple obstruction or adhesion of lacrimal duct was 4.4%(3 eyes/68 eyes), which was significantly lower than 94.1% of membranous obstruction at the lower end of lacrimal passage(273 eyes/290 eyes), the difference was statistically significant(χ²=251.134, P<0.05).

CONCLUSION: Lacrimal duct probing can be used for most congenital dacryocystitis and can relieve the symptoms of dacryocystitis effectively. The operation is simple, safe and reliable, but the therapeutic effect is closely related to the type of lacrimal passage obstruction.

Abstract:AIM: To summarize the characteristics of ocular perforation caused by metallic foreign body, evaluate the effectiveness and safety of 23G vitrectomy, and analyze the factors that affect the final vision of patients with ocular trauma score.

METHODS: Continuous observation and analysis from July 1, 2014 to June 1, 2016, hospitalized in our hospital caused by metallic perforating ocular trauma for 23G vitrectomy in 38 cases(38 eyes). A prospective collection of patient included age, gender, eye, place of occurance of trauma, foreign body size, wound length, foreign body position, initial visual acuity and final visual acuity, macular etc.. The ocular trauma score(OTS)system was used to assess the effectiveness and prognosis of the patients. The follow-up time was over 6mo.

RESULTS: There were 38 eyes in 38 patients, including 37 males and 1 females, aged 16y-56y. Ocular trauma mainly occurred in the workplace, 33 cases accounted for 87%, followed by sports venues, 3 cases accounting for 8%. Corrected visual acuity more than 0.1 in eyes with intraocular foreign bodies underwent 23G vitrectomy were 21 cases, accounting for 55%. Preoperative retinal detachment, large foreign body(more than 5.0mm), damage of lens were important factors of poor prognosis. Foreign bodies were located in the vitreous body in 23 cases, accounting for 61%, located in the retina in 15 cases, accounting for 39%. When admitted to hospital, the patients suffered from retinal detachment in 21 cases(55%), endophthalmitis in 7 cases(18%), the size of intraocular foreign bodies(IFOB)was larger than 5.0mm in 7 cases(18%), severe postoperative proliferative vitreoretinopathy(PVR)was in 6 cases(16%), epiretinal membrance of macula in 5 cases(13%). Of the same OTS scores, visual acuity in 6mo was significantly better than preoperative; no matter preoperative vision or postoperative vision in 6mo, the higher the OTS scores, the better the visual acuity.

CONCLUSION: The ocular perforation caused by metallic foreign body mostly occurs in young men under 40y, and the main reason is injury in the workplace. No protective measures are adopted. The main factors affecting the final visual acuity are retinal detachment, foreign body greater than 5.0mm and postoperative PVR appearance after the injury, vitrectomy time has little effect. The 23G vitrectomy is safe, reliable and effective in the treatment of ocular penetrating injuries due to metallic foreign bodies. OTS score can be used effectively in patients with ocular perforation caused by metallic foreign bodies and make reasonable and useful postoperative visual acuity prediction.

Abstract:AIM: To investigate the clinical effect of reconstruction of orbital blowout fracture by conjunctival incision combined with Medpor Titan implantation under nasal endoscopy.

METHODS: Sixteen patients(16 eyes)diagnosed with orbital blowout fracture, include medial fractures, floor fractures and extended fractures, were performed reconstruction by transconjunctival approach with implant material- Medpor Titan under nasal endoscopic-assisted; observation of postoperative visual acuity, eyeball protrusion, extraocular movement limitations, diplopia, orbital CT, occurrence of implanted material rejection was taken.

RESULTS: A 3-month follow-up was performed and the therapeutic efficacies of anatomic and functional recovery were evaluated. No further vision loss or infection occurred postoperatively. In the 16 patients, the average postoperative observation was 3mo, enophthalmos were fully corrected, diplopia disappeared. Orbital(CT)did not reveal implant displacement and rejection postoperatively.

CONCLUSION: Endoscopic-assisted reconstruction of orbital blowout fracture by conjunctival incision combined with Medpor Titan implantation is a safe and effective surgical method with the characteristics of with direct operation, clear range of fracture exposure and safe and reliable operation, not only restores the patient's visual function and appearance, but also reduces the incidence of complications, avoiding postoperative facial scar.

Abstract:AIM: To measure the tear film thickness when with a good fitted night wear orthokeratology lens in youth, and observe the change of corneal parameters.

METHODS: From July 2015 to August 2016, 51 eyes of 26 teenagers with myopia who would wear orthokeratology and accept regular follow-up were enrolled. The mean spherical equivalent refraction of teenagers was -2.78D±1.53D(-1.00D to-6.00D)before wearing orthokeratology, and the mean astigmatism was 1.29D±0.61D(0 to -2.68D). The tear film thickness were measured by optical coherence tomography(OCT)when the eyes wearing orthokeratology for 1mo. The surface regularity index(SRI)value was measured by corneal topography to compare its relationship with the tear film thickness and the changes of corneal anterior surface parameters during the period of wearing lens were observed.

RESULTS: At 1mo after wearing orthokeratology, the mean tear film thickness of right eyes was 230.09±10.40μm, and that was 224.38±10.57μm of left eyes. The mean tear film thickness was 228.75±9.66μm in male eyes and that was 224.80±6.74μm in female eyes. The mean tear film thickness of all eyes was 227.05±10.29μm, and the mean SRI value was 0.16±0.14. There was no correlation between tear film thickness and SRI value(P>0.05). The FK value, SK value and average K value from before wearing to after wearing for 2d and 1wk gradually decreased, the difference was statistically significant(P<0.05). There was no statistical difference among wearing for 1wk, 1, 3 and 6mo(P>0.05).

CONCLUSION: OCT can be used as a safe and reliable method for measuring the thickness of the tear film space during the wearing of orthokeratology, which may be of certain value for the safety assessment of the long term wearing of orthokeratology. Orthokeratology works very quickly, corneal curvature decreases rapidly 2d after wearing and stabilizes during the period.

Abstract:AIM: To investigate postoperative binocular visual function reconstruction in intermittent exotropia children with binocular visual training.

METHODS: The clinical data of 108 cases of intermittent exotropia children admitted to our hospital from April 2013 to April 2016 were retrospectively analyzed. Among them, 45 cases with binocular visual function training were included in the control group; the other 63 cases with TSJ-IV synoptophore training software for binocular vision training were included in the observation group. The binocular visual function reconstruction and eye position regression of the two groups were observed.

RESULTS: Baseline data of binocular visual function and strabismus in two groups had no significant difference before surgery(P>0.05). At 3mo after operation, the visual function of grade three in the observation group was significantly improved, and the proportion of simultaneous vision, visual fusion and stereopsis in the observation group were significantly higher than those in the control group(P<0.05). The proportion of patients with macular stereopsis and foveal stereopsis in the observation group was significantly higher than that in the control group, and the proportion of patients without stereopsis in the observation group was significantly lower than that in the control group, and the difference was statistically significant between groups(P<0.05). At 3mo after operation, the proportion of strabismus ≤30^△ in the observation group was significantly higher than that in the control group, with statistical significance(P<0.05). In addition, the eye position regression rate of the observation group was significantly lower than that of the control group in the postoperative 1a follow-up, and there was significant difference between the two groups(P<0.05).

CONCLUSION: The children with intermittent exotropia taking postoperative synoptophore training can promote binocular visual function reconstruction, ameliorate the degree of strabismus, and avoid postoperative eye recession.